Ten focus group sessions were held in Imo State Nigeria to explain the under-utilization of public sector health services. Groups consisted of village women, village men, elementary school teachers, traditional medical practitioners, male civil servants, female civil servants and nursing staff. Rural and urban sites were selected in major sub-cultural zones. Focus groups revealed under-utilization had several causes: limited accessibility of services; high user costs; lack of supplies; uncaring attitudes of staff; nepotism and financial misappropriation. Implications for government action are suggested: strategies for reducing costs; making health care more accessible; improving the quality of services and educating the consumer. The role of the state in health care may need clarification to ensure it complements non-state health care provision. Suggestions are made for further research in which focus group studies can be used throughout.
Health managers wishing to understand poor health service utilization - particularly in a West African context will find this useful.
Government of Nigeria